Republic of the Philippines

Department of Education
REGION XI
Division of Davao Occidental

EQUIVALENT RECORD FORM

Name: ___________________________________________ Date of Birth:___________ Sex:__________

(Surname) (Given) (M.I.)
Employee No: _______________________________Authorized Position Title: _____________________
Item No: __________________P.D. No._____________ ___Authorized Salary: _________________
I Educational Attainment and Civil Service Eligibility
Civil Service
Title, Degree or Highest Attained Name of Institution Year Examination Rating Date
Received

II. Service Record ATTACHED DULY CERTIFIED SERVICE RECORD

III. Equivalent Units
A. Total No. of years teaching (Public only) ____________ ___________ __ ___________
B. Degree to degree equivalent (present degrees) ____________ _____________ ___________
C. Areas Equivalent School Year No. of Units Descriptions

1. Professional Study ____________ _____________ ___________

2. Teaching Experience
a. Public school ____________ _____________ ___________
b. Private school ____________ _____________ ___________
3. Adm. Supervisory Experience ____________ _____________ ___________
a. Public school ____________ _____________ ___________
b. Private school ____________ _____________ ___________
4. Others (seminars, workshop, etc.) ____________ _____________ ___________
TOTAL ____________ _____________ ___________
LATEST EFFICIENCY RATING: ________________________
RECOMMENDING APPROVAL: _________________
__________________ Teacher’s Signature
Principal
NOTE: Teachers do no write below
IV. Division Action Date Range Salary Ranged Scheduled Remarks
Classification Processed Assignment Salary

JINKY B. FIRMAN, CESE ALOYSIUS CESAR C. BRAVO

Asst. Schools Division Superintendent Administrative Officer V

V. DepEd Office Action:

Classification__________________________ Range _______________________________
Date Approved/Processed:_________________________ Post Audited at Range ______________
(For Future reference)
DEPARTMENT OF EDUCATION
POST AUDITED OF TEACHING POSITION
CLASS TITLE _________________________ APPROVED:
SALARY GRADE____________________________
SUBJECT TO AVAILABILITY OF ITEM REYNALDO B. MELLORIDA, CESO VI
Schools Division Superintendent
 OATH

I hereby certify that I have been actually enrolled in the school or schools listed in the accompanying
transcript of record and that I have earned the units indicated therein.

As required, the Department of Private Schools has been furnished with authentic copies of the sworn
statement of its closure.